HomeMy WebLinkAboutBLD2023-01099 - BLD CD Environmental Health Review - 9/13/2023 MASON COUNTY FcrmtNo:�IJJALriJ'D1011
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center,Building,Planning ?
SEP 13 2023 rr
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFOORMATION: CONTRACTOR INFORMATION: _
.NAME: e, AlI LC NAME: ZE s1p1S&zs zle. _
MARLING ADDRESS: r giaSK MAILING ADDRESS: n BDar d'7.SS m O
PHONESEK'� STATE: 1�A_9P: 85at CITY:
-B4 ATEy�Z7P: D Z
PRONEM7: C- �y/ TENoA PHONE: CELL r'
PHONEA2: _ EMAIL;�T\: Aa..a Q!FJIA
EMAIL: k, s I,&.I REG 9.,/ EXP.I 8/� = Z
PRIMARY CONTACT: OWNER CON'[RACTORQ OTNHR❑
LAMB - EMAIL D
MAILING AgqDRESS CITY 'aR1 STATH ZiP r
PHONE .7[� -'.34/- 7SO CELL Aw!'
PARCEL INFORMATION:
PARCELNUMBER(12 Digit Nmlb ) 3221y-13— qW8/ ZONING
LEOALDESCRDTTON(AbMeviarcd) L.T'A DCSp /MKS 4/ FIE DISTRICT 3 N
SITE ADDRESS r CITY 9 a8 m mO
DH ELTIONS TO ST[E ADD�ySk-� n
'gy m eaC /RFT S a e/I GHaaE On//��,, � � r
O THE PROJECT WTTINN m FTOF SLOPES)GREATERTHAN 14%: YES[] NO m/9NOW WAD:�par• T ^a
0
ISPROPRRTY WrtBN'200 FT OF iHL FOLLOWING: rca,.ixllml.muy):
SALTWATER LAKE RIVER/CRP.EICQ PONDQ WETLAND SEASONAL RUNOFFS STREAM
TYPE OF WORK: NEW ADDITION❑ ALTEpRRATIO`N`��❑ _REPAIR❑ OTHER ❑
USE OF STRUCTURE0,w,o cvra¢e.cowwa -,`g,—) f.CS'w1WM!—
ISUSE: PRIMARYp SEASONAL[] NUMBER OF HEDROOMS�_NUN(BE_R OF RAnm00MS nI
]IEATEDSTRUCNUREI YES/w.bgv YES fFaN+I Ma ❑ NO❑
DESCRffiE WORK N4Sf1 Nvn..CrcL+Ic� tVyn� 3 beet JZ
SOVARE FOOTAGE:ip,opwa9
ISTFLOOR_f 452K.R. 2NDFLOOR aq.R IRDFLOOR aq.R. BASEMENT aq.R
DECK_. _,& COVERED DECK aq.R STORAGE sq.R OTHER sq.A.
GARAGE_p.A. ARa [3 DmehM❑ CARPORT ul.It. AfWW[] Dem []
MANUFACTURED HOME INFORMATION: •4 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE 5 -014ft tv MODEL 12PtC r YEAR ab2,3 LENGTH 601
WIDTH BEDROOMS— RAGUS a SERW.NUMBER
ENVIRONMENTAL HEALTH: �/
SEWAGESEWERSOURCE_ SEPTIC[j SEWER❑ I NEW EXISTING❑
PLUMBINGINSTRUCTIIRE? YES NO❑ .a...�Tfy ,a8achcaw Il Wa Adequary Form
PERMECEI/ UNDATION DRAIN ET
S PROPOSED? YES NOTIy� HDSTINGSQ.FT.
EXISTINGBEDROOMS PROPOSMBEDROOMS _
OWNER ackroMetlSea tlwI wCmpYn d'mevarele inlmnel'vm mry wAl In a abp wM1 ordxwpmil momlbn.MYnwcletlpamaKtl WrYb/
ypphee LaUw.l EeOare Pei l em Ilse axner aM I IUMer Jedare Nat l am an4WJ to twee tlrs permit anE bM IMxpAipNp®E.I IIWa
aWir�yanilssian M1cm all Pe resasary partiea.lnd Wing eny exemanl adOx pr pMlecot Wemsl regaMlnp pb prciapL 1MgwW pYgM
rgewrilatiw,regaeems Peltln infamNan provvb]V acwrab anE 9nMa empbyew W IMacn Wrily axau b IM Wwe EuulMO gtpety
ub s0ubrep)M miweM ITVµ Nwi.Thi.parmNegAlceum Marnn null a vdtl mwrk ore WnetrM mnmuclba k mlmrmenmE Mtlb 1a]
am m mmnwucupn eax b awpmaee rota pwbl tl I�dava
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTNITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE PALL CAUSE THE APPLICATION TO BE EXPIRED.(MARON
X ^ I �r COUNTY CODE 14.08A3)
5�:.w Mwt be aiurlM MMa DWNHR, � DW
DEPARTMENTAL REVIEW APPROVED DATR DENIED DATE.' TAG&TIOTFS/CONDTHONS . -
BUIDINGDEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH C I
_ _.. PROVED 330 - �' •}r M SO OUNTY DCD PLANNING
5.
,
TE PLAN REQUIRED TO BE ON SIT ,• p
CHANGES SUBJECT TO APPROVAL
_H AP !0VE0 y ` VA
By: /"" Date: 09/14/202 *.ome+m oeavmz. 4 31 NE {� A V A—
EH Setbacks -�
A.) Droinlie /Reserve requires 10'SelOack M1om bogngdoundadan
B.f SepNct kls)requlres 5'setback M1om ell fcclingdgunda4ons
C.)No fou aeoNPedmeter pains wtlM1in 3(11.downgradienl at '
DrvnlieldlRbserve area
0.1 NO Cut nk(5J(greater Man 5a aM over 0. degrees)vMkin�
5m,down adianl of Drainlield/Reserve area S
b{OT AN APPROVED SEPTIC DESIGN
must use BWG 2022-00370 tar septk installation f
1
i l
I
,S)
I i I
I
'^ 4 I PLANNING SETBACKS
Front: 25'
Rear and Side: 20'
w I 'Subject to EH Setbacks
W �L° PLANNING:
ALL SETBACKS ARE MEASURED FROM
I THE FURTHESBT ILDIN PROJECsCTION OF THE
1 330' -- --
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